Non-small cell lung cancer is one of the most common types of lung cancer that occurs in both smokers and non-smokers. Immune checkpoint inhibitors have emerged as an effective treatment for NSCLC, but they have been associated with multisystem immune-related adverse events (irAEs). This study aims to determine the association of multisystem irAEs with survival and risk factors.

This retrospective cohort study included a total of 623 patients with stage III/IV NSCLC who were treated with anti–PD-(L)1 ICIs. The primary outcome of the study was the diagnosis of multisystem irAEs as characterized by the combinations of individual irAEs involved.

The findings suggested that 148 patients (24%) developed a single irAE, and 58 patients (9.3%) developed multisystem iRAWs. Pneumonitis thyroiditis, dermatitis pneumonitis, hepatitis thyroiditis, and dermatitis thyroiditis were the most common multisystem irAE patterns. A longer duration of immune checkpoint inhibitors was an independent risk factor for the development of multisystem irAEs. Besides, patients with 1 irAE and multisystem irAEs had a statistically improved overall survival and progression-free survival compared with patients with no irAEs.

The research concluded that the development of multisystem irAEs was linked to improved survival in patients with NSCLC with immune checkpoint inhibitors.